Value of transvaginal ultrasonography in the diagnosis of endometrium abnormalities in patients treated with tamoxifen

ABSTRACT

This study was conducted to investigate the value of endovaginal ultrasound in the assessment of tamoxifen associated changes of the endometrium in patients with breast cancer and to correlate sonographic and pathologic findings to symptoms and duration of tamoxifen therapy. Medical records and sonograms of 80 post-menopausal women treated for cancer breast with adjuvant tamoxifen therapy were reviewed retrospectively. Endometrial thickness was recorded as a single layer thickness and considered abnormal when greater than 2.5 mm for post-menopausal women. Sonographic endometrial thickness was correlated to histologic findings, symptoms and duration of tamoxifen therapy. Fifty seven of 80 post-menopausal women had single layer endometria1 thickness of 2.5 mm or greater measured by TVS and 55 of 57 had endometrial biopsies or dilatation and curettage. Biopsies detected 24 cases of abnormal endometrial including endometrial carcinoma [2], breast carcinoma metastatic to the endometrium [one], endometrial polyps [13], tuba1 metaplasia [3] and benign endometrial hyperplasia [5]. Using a single- layer endometrial thickness greater than 2.5 mm by TVS, 21 of 24 women with abnormal endometrial were detected. Women with abnormal pathologic findings had a significantly thicker mean single layer endometrial thickness than those with normal findings [7 mm versus 4 mm]. Twelve women had post-menopausal bleeding all of whom had a single layer endometrial thickness greater than 2.5 mm on TVS